Medical Journal of The Islamic Republic of Iran (MJIRI)

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  Background : Magnesium is the second most abundant intracellular cation. It plays an important role in insulin homeostasis and glucose metabolism through multiple enzymatic reactions. With increasing data on magnesium deficiency in diabetic patients and epidemiological studies demonstrating magnesium deficiency as a risk factor for diabetes, it is logical to search for its possible beneficial effects on diabetes control and prevention. We aimed to determine whether oral magnesium supplementation improves metabolic control, lipid profile and blood pressure in patients with type II diabetes.

  Methods : Fifty four patients with type II diabetes were included in a randomized double blind placebo-controlled clinical trial.Patients received either placebo or 300 mg elemental magnesium (as magnesium sulfate -MgSo₄-) daily, for 3 months. Metabolic control, lipid profile, blood pressure, magnesium status, hepatic enzymes, hemoglobin concentration, and anthropometric indices were determined in the beginning and at the end of the study.

  Results: Daily administration of 300 mg elemental magnesium for 3 months, significantly improved fasting blood glucose (183.9±15.43 to 125.8±6.52 vs. 196.5±28.12 to 136.5±7.94, p< 0.0001), 2-hour post prandial glucose (239.1±74.75 to 189.1±60 mg/dl vs. 246.4±97.37 to 247.8±86.74 mg/dl, p< 0.01), lipid profile, blood pressure and hepatic enzymes.

  Conclusion: Oral magnesium supplementation with proper dosage has beneficial effects on blood glucose, lipid profile, and blood pressure in patients with type II diabetes.

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Background: Type 2 diabetes is a growing public health problem and is associated with increased morbidity and mortality. The worldwide prevalence of type 2 diabetes is rising. Polyphenols, such as flavonoids, phenolic acid, and stilbens, are a large and heterogeneous group of phytochemicals in plant-based foods. In this review, we aimed at assessing the studies on polyphenols and diabetes management.
   Methods: A literature search in the PubMed, EMBASE, Scopus, and ISI Web of Science databases was conducted to identify relevant studies published from 1986 to Jan 2017.
   Results: Several animal models and a limited number of human studies have revealed that polyphenols decrease hyperglycemia and improve acute insulin secretion and insulin sensitivity. The possible mechanisms include decrease in glucose absorption in the intestine, inhibition of carbohydrates digestion, stimulation of insulin secretion, modulation of glucose release from the liver, activation of insulin receptors and glucose uptake in insulin-sensitive tissues, modulation of intracellular signaling pathways, and gene expression.
   Conclusion: Growing evidence indicates that various dietary polyphenols may influence blood glucose at different levels and may also help control and prevent diabetes complication. However, we still need more clinical trials to determine the effects of polyphenols- rich foods, their effective dose, and mechanisms of their effects in managing diabetes.
 

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Background: Social capital is an important interpersonal organizational resource that may affect health behaviors and seems to be an important factor in chronic diseases. Considering the lack of evidence on this topic, in the present study, we aimed at investigating the association between components of social capital, socioeconomic condition, and controlling Type 2 diabetes mellitus in Iran.

   Methods: This study was conducted on 300 patients with Type 2 diabetes in Tehran, Iran. In this study, simple random sampling method was used for data collection. Path analysis model was used to examine the potential association between social capital components and to determine the factors that control Type 2 diabetes.

   Results: In the present study, most of the participants were female (70.7%) and married (78.7%). Path coefficients were calculated by a series of multiple regression analyses based on the conceptual model. The final model had a proper fit with Chi-square = 2.08 (DF = 1, P = 0.049), GFI = 0.542, AGFI = 0.915, NFI = 0.228, RFI = 0.284, IFI = 0.299, TLI = 0.292, CFI = 0.219, and RMSEA = 0.033. The Groups and networks (network) (β = 0.051, p = 0.036) and trust and solidarity (β = -0.018, p = 0.028) had a direct positive and negative effect on HbA1C, respectively. The results also revealed that education levels had a direct positive effect on groups and networks (network) (β = 0.118, p = 0.036), trust and solidarity (β = 0.082, p = 0.007), information and communication (β = 0.037, p = 0.027), and contribution in team works and public activities (β = 0.064, p = 0.003). In addition, education levels had an indirect positive effect on HbA1C through their effect on groups and networks (network), trust and solidarity, and information and communication.

   Conclusion: Social capital has a significant relationship with diabetes. Although it was not specified clearly which components of social capital were associated with diabetes, trust and solidarity showed a negative direct effect on HbA1C, respectively. Therefore, developing and implementing local and collective programs to build trust and increase the standards of social trust in patients with diabetes can be effective in controlling HbA1C.

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Background: Magnesium deficiency plays a key role in obesity and decreases insulin sensitivity. In our previous study, significant evidence was provided for the contribution of oral Mg supplement that could improve insulin sensitivity and body weight in animal trials. The purpose of the present study was to investigate the effects of an herbal supplement containing 300 mg magnesium sulfate on lipid profile, as well as insulin resistance and secretion in overweight patients.
   Methods: Seventy overweight non-diabetic volunteers with Body Mass Index (BMI) >28 kg/m2 were included in a randomized double blind placebo-controlled clinical trial (ethic number HUMS REC.1394.57) and registered in Iranian Registry of Clinical Trials (IRCT2012110124756N2 with registration number 24756). They received either placebo or an herbal supplement capsule containing 300 mg magnesium sulfate (MgSO₄) for 6 months on a daily basis. Metabolic control, lipid profile and magnesium status were determined at baseline and every three months. Student t-test, repeated measure ANOVA and ANCOVA were used to compare the groups.
   Results: There was no significant difference between groups before intervention, but daily Mg supplement for 6 months significantly improved fasting insulin level (6.71±0.11 to 6.27±0.3 three months after Mg therapy, p<0.01 vs. 6.41±0.11 in control group (5.83±0.063)  six months after Mg therapy, p< 0.0001),  HOMA-IR (1.52±0.03 )in control group to 1.36±0.03 after three months Mg therapy, p<0.05 vs 1.37±0.05 in control group to 1.22±0.02 six months after Mg therapy, p< 0.05), high density lipoprotein cholesterol (HDL) (43.57±0.82 in control group to 43.91±1.92 three months after Mg therapy, p<0.001vs 43.57±0.82 in control group to 46±0.88 six months after Mg therapy, <0.01), triglyceride (TG) (163.17±6.1 in control group to 141.2±5.84 six months after g therapy, p<0.05) and low density lipoprotein cholesterol (LDL) (112.62±3.41 in control group to 104.42±2.35 six months after Mg therapy, p<0.05).
   Conclusion:  Oral herbal supplement containing MgSO₄ (300 mg/day) could improve plasma insulin level, lipid profile, and insulin resistance in non-diabetic overweight volunteers.
 

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Background: Various studies have shown the benefits of using glucocorticoids following surgery. However, side effects associated with drug administration have been investigated sufficiently. We aimed to evaluate the effects of different doses of dexamethasone on blood glucose concentration in patients undergoing elective abdominal surgery.
Methods: This double-blind clinical trial design study was conducted among 90 candidates of elective abdominal surgery referred to RasoolAkram Medical Complex  in Tehran ,Iran, 2017-218. Patients included two groups of intervention: group I, received 4 mg dexamethasone; group II, received 8-10 mg dexamethasone; and group III (control group), received ondansetron after induction of general anesthesia. Data were analyzed using ANOVA, Kruskal-Wallis test, and repeated measures. α=0.05 was considered as a statistically significant level.
Results: The highest increase in blood glucose concentrations in all three groups occurred in the first 6 hours after the surgery. The lowest intensity of pain in all the groups occurred in the first 24 hours after the surgery. All the groups showed statistically significant changes in blood glucose concentration and pain intensity. Comparing among the mean blood glucose concentrations over time, there were statistically significant changes in time and group/time (p<0.001).  Comparing the mean intensity of pain over time,  statistically, significant changes were observed  in  time and group / time (p<0.001).
Conclusion: In general, change trends in blood glucose concentration and pain intensity could be dependent on the medication used and its dose, as well as the time of drug administration. Changes in blood glucose levels in the control group can be attributed to metabolic changes caused by surgical trauma.